Evaluation of a Social Network HIV Prevention Intervention Program for Young Men Who Have Sex with Men in Russia and Bulgaria

Abstract

HIV prevention, by intervening within social networks, is potentially important but highly understudied. Approaches that systematically identify, train, and enlist known social influence leaders to advise members of their own networks in risk reduction constitute ways to reach hidden population segments, persons who are distrustful of authorities but trust their peers, and those who cannot be reached through traditional professionally delivered counseling. This article illustrates and provides evaluation data on a program that recruited 14 intact social networks of young men who have sex with men (YMSM) in St. Petersburg, Russia, and Sofia, Bulgaria. Sociometric measures were used to identify the social leader of each network, and baseline risk assessment measures were administered to all members of each social network. The sociometrically determined leaders then attended a six-session group program that provided training and guidance in how to carry out theory-based and tailored HIV prevention conversations with members of their own social networks. Four months after leaders completed the program, all network members were readministered risk assessment measures. Pre- to postintervention data revealed that the program produced: (1) increases in the level and comfort with which network members talked about AIDS prevention topics in their daily conversations; (2) increased network-level AIDS risk reduction knowledge and improved risk reduction norm perceptions, attitudes, behavioral intentions, and self-efficacy; and (3) increased condom use levels among network members. Although not a controlled, randomized trial, these program evaluation findings strongly support the feasibility of social network-level HIV prevention approaches.

Evaluación de un programa de intervención para promover la salud sexual en adolescentes mexicanos en conflicto con la ley.

“…Por esta razón, dotar a los jóvenes de información es el primer paso para lograr que identifiquen el riesgo de contraer el VIH, teniendo en cuenta que cuando las personas están informadas pueden adoptar una postura diferente (Amirkhanian, Kelly, Kabakchieva, McAuliffe y Vassileva, 2003).…”

“…Posiblemente este hallazgo se deba, por un lado, al uso de la estrategia de anuncio publicitario que, como se ha visto en otros estudios, contribuye para que los adolescentes desarrollen una mejor actitud hacia el uso del condón (Callejas et al, 2005); y, por otro lado, al entrenamiento utilizado en habilidades para mejorar la eficacia en el uso del condón (Amirkhanian et al, 2003).…”

Identifying Leaders and Followers in Online Social Networks

“…For advertising, to improve the effectiveness of word of mouth advertising and increase the recommendation based product adoption, advertising companies want to give free samples to leaders instead of a random population [12]. For community health campaigns, such as HIV prevention programs [2] and schoollevel anti-smoking campaigns [22], targeting interventions at community leaders have been shown to be more effective than applying them to random individuals. Introducing new ideas to leaders of communities maximizes their spread to the rest of the population and is an effective way of indirectly reaching individuals that shy away from authorities.…”

“…The goal was to study the impact of social network structure and social capital on team performance. Likewise, Amirkhanian et al [2] collected survey data from 14 social networks in Russia and Bulgaria to identify leaders within them.…”

The relevance of social network analysis on the epidemiology and prevention of sexually transmitted diseases

“…Individual relations can explain someone's adoption of an innovation (egocentric level), while the network structure and the position of the individual on it can explain the speed of the diffusion and its final reach. Two studies can be found which utilize leadership training in their communities (populations) to diffuse preventive measures against HIV, both showing results that apparently favor the strategy, one in India 30 , and the other one in Russia and Bulgaria 31 .…”